Advertisement

Dental caries on CT in the ER population: prevalence and reporting practices

  • Jesse T. Brandfass
  • Adam C. Ulano
  • Joshua P. Nickerson
  • Michael P. Bazylewicz
Original Article
  • 21 Downloads

Abstract

Purpose

Although dental caries can be identified on CT and may be treatable, the literature provides little, if any, guidance on the responsibility of a neuroradiologist in reporting them. Untreated dental caries can impact diet and nutrition and can result in a variety of complications such as an odontogenic abscess, tooth loss, sinusitis, and dental pain, which can impact quality of life. The estimated prevalence of untreated dental caries in adults is 27%. In our experience, the prevalence of untreated dental caries in patients presenting to the Emergency Department (ED) is higher but dental caries are often unmentioned or unrecognized. We aim to determine the frequency of unreported dental caries and propose a paradigm for reporting and management.

Methods

Our research was IRB-approved and HIPPA compliant. We searched the radiology database for adult patients who underwent a CT of the facial bones while in the Emergency Department between January 1, 2015 and June 30, 2015. The examinations were reviewed by a faculty neuroradiologist for the presence of untreated dental caries. Untreated dental caries were documented and characterized by depth. Caries that were partially or completely obscured by dental amalgam artifact were excluded. The radiology reports were reviewed to evaluate reporting frequency. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software.

Results

A total of 200 patients (113 male, 87 female; age 18–98 years) underwent 200 CT examinations of the facial bones. One hundred fourteen (57%) patients had at least one dental caries. When caries were present, 14.9% of radiology reports included caries in the findings section and 9.6% of the reports mentioned caries in the impression.

Conclusions

The presence of dental caries should be mentioned in the radiology report. The prevalence of untreated dental caries is higher in our cohort than reported in the general population, and dental caries are underreported by neuroradiologists at our institution. A paradigm for reporting and management was created upon collaboration with faculty from the University of Vermont Dental and Oral Health practice. A visit with a dentist should be recommended within 6 months if caries are limited to the enamel, within 3 months if caries involve the dentin, and within 2 weeks if caries extend in to the pulp. Further research is necessary to determine the clinical impact of improved reporting.

Keywords

Caries Dental caries Teeth Cavity Dental Caries on CT Dental CT Teeth CT Teeth facial bones Caries facial bones Reporting dental caries Caries recommendations 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.

References

  1. 1.
    Van Lanker A et al (2012) The association between malnutrition and oral health status in elderly in long-term care facilities: a systematic review. Int J Nurs Stud 49:1568–1581CrossRefGoogle Scholar
  2. 2.
    Metzger Z, Abramovitz I, Bergenholtz G (2003) Apical periodontitis. In: Bergenholtz G, Horsted-Bindslev P, Reit C (eds) Textbook of endodontology. Blackwell, Oxford, pp 113–126Google Scholar
  3. 3.
    Pokorny A, Tataryn R (2013) Clinical and radiologic findings in a case series of maxillary sinusitis of dental origin. Int Forum Allergy Rhinol 3(12):973–979CrossRefGoogle Scholar
  4. 4.
    Bomeli SR, Branstetter BF 4th, Ferguson BJ (2009) Frequency of a dental source for acute maxillary sinusitis. Laryngoscope 119(3):580–584CrossRefGoogle Scholar
  5. 5.
    Longhini AB, Ferguson BJ (2011) Clinical aspects of odontogenic maxillary sinusitis: a case series. Int Forum Allergy Rhinol 1(5):409–415CrossRefGoogle Scholar
  6. 6.
    Scheinfeld MH, Shifteh K, Avery LL, Dym H, Dym RJ (2012) Teeth: what radiologists should know. Radiographics 32(7):1927–1944CrossRefGoogle Scholar
  7. 7.
    Dye BA, Thornton-Evans G, Li X et al (2015) Dental caries and tooth loss in adults in the United States, 2011–2012. NCHS Data Brief No. 197. Centers for Disease Control and PreventionGoogle Scholar
  8. 8.
    Christensen GJ (2015) Preventing and treating caries in mature adults. Dental Economics. https://www.dentaleconomics.com/articles/print/volume-105/issue-12/science-tech/preventing-and-treating-caries-in-mature-adults.html. Accessed June 2017
  9. 9.
    Crystal YO, Marghalani AA, Ureles SD et al (2017) Use of silver diamine fluoride for dental caries management in children and adolescents, including those with special health care needs. Pediatr Dent 39(5):E135–E145Google Scholar

Copyright information

© American Society of Emergency Radiology 2019

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of Vermont Medical CenterBurlingtonUSA
  2. 2.University of VermontBurlingtonUSA

Personalised recommendations